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Qualities
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Home A
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Home B
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Home C
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Nurses per resident
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Nurse’s aides per resident
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Nurses training
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Nurse’s aides training
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Director of Care—qualifications
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Recreation workers per resident
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Trained as recreation therapist?
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Recreation director—trained as R.T.?
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Social Worker- how often
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Training of social worker
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Physical therapist
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On site?
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Occupational therapist
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On site?
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Other rehabilitation Staff
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Registered Dietitian available
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Registered Dietitian on site
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House Physician
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Access to geriatric physician
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Access to mental/ geriatric mental health
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Pharmacist available
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Pastoral Care
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Art Therapy
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Music Therapy
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Other
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Cleanliness
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Lighting
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Smell
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Access to Outdoor space
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Access to Shops/Shopping
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Equipped for wheelchairs
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Handrails
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Rails/bars in bathrooms
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Pets allowed/available
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Plants allowed/available
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Atmosphere
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Visiting Hours
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Can take residents out as wish
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Management seems flexible
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Care conferences—frequency
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Educational programs for staff
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Accredited
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Survey Results
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Single Rooms
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Double Rooms
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Appearance of rooms
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Size of rooms/room space
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Storage in rooms
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Lighting in rooms
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View From Rooms
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Can bring in own furniture
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Bring in TV
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Cable Ready
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Can have telephone in room?
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Call bells by bedside
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Call bells by toilet
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Distance of rooms from dining/activity
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Floors/ Elevators
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Residents appear well dressed
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Residents appear clean
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Residents appear happy/content
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Staff appear helpful, interested
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Staff appear to have good relations
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Staff turnover
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Management is open to family input
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Resident’s Council
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Family Council
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Recreation programs—number
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Recreation programs variety
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Recreation programs—evenings
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Recreation programs-weekends
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Lifestyle programs/opportunities
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Independent Living
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Assisted Living
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Nursing Home
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Acute Care
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Dementia Unit
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Limitations on Care acuity/levels
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Dining Room cleanliness
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Dining room atmosphere
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Dining Hours appropriateness
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Appearance of food
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Variety of Menu
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Proportions appropriate
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Choices/Alternatives available
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Meals served in rooms
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Family can join residents
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Laundry done on premises
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Laundry how often
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Can family do laundry
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Policy on Theft
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Policy on Abuse
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Policy On Restraints
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Policy on Roommates
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Policy on Room Changes
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Copy of Admission agreement
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Copy of recreation schedule sample
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Copy of menu
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How does it feel to you? Notes
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